Childhood Immunisation Disclaimer

Please submit the form below if you do not want your child immunised against diseases.

I/We understand you may have some concerns regarding your child’s immunisations.

You should read the Department of Health (DoH)Reference guide to consent for examination or treatment before making a decision.

Please also see details below for the ‘Vaccine Knowledge’ website. Here you will find evidence-based based independent information about immunisations, including frequently asked questions:
http://vk.ovg.ox.ac.uk

If, after reading the above, you have decided for your child not to have the vaccination(s), use this form to opt out. Your child can be restored to the vaccination schedule at any time by contacting the practice.

Statements

I/We understand that the Primary Childhood Immunisation schedule will protect my child from Diphtheria, Tetanus, Pertussis (whooping cough), Polio, Haemophilus influenzae type b, Hepatitis B, Meningococcal B, Pneumococcal, Rotavirus, Meningococcal C, Measles, Mumps, and Rubella diseases.

I/We understand that by not having the Primary Childhood Immunisation schedule, my child will be at risk of contracting vaccine-preventable diseases. I understand that by not having the Primary Childhood Immunisation schedule, my child can spread these vaccine-preventable diseases to other vulnerable children and adults.

I / We understand that the Department of Health (DoH) states that immunisation is an “important decision” and immunisations should not be administered if two adults with parental responsibility cannot reach an agreement. If one adult consents and the other disagrees, the immunisation should not be carried out unless both adults with parental responsibility agree to it.

I / We would like to advise the practice that I/we do not wish for my/our child to participate in the NHS childhood immunisation schedule.